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Peroneal Tendinopathy(Tendinopathy, Peroneal; Peroneal Tendonitis; Tendonitis, Peroneal; Peroneal; Peroneal Tendon Injury)

Pronounced: Per-o-NEE-al ten-din-AH-path-ee

Definition

Tendinopathy is an injury to the tendon. It can cause pain, swelling, and limited movement. The injury can include:

  • Tendonitis—inflammation of the tendon
  • Tendinosis—tiny tears in the tendon tissue with no significant inflammation

The peroneal tendons run along the outside of the ankle bone. Treatment depends on the severity of the injury.

Causes

Peroneal tendinopathy often occurs as a result of:

  • Repetitive overuse injuries which may occur from regular activities
  • Trauma to the ankle such as a sudden twisting of the ankle or foot
  • A sprained ankle that turned inward
  • Overstretching the foot
Risk Factors

Factors that increase your risk of peroneal tendinopathy include:

Symptoms

Symptoms include pain, tenderness or swelling along the bottom of the foot or side of the ankle. You may also experience weakening or instability in the foot or ankle.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Your doctor may also need images of the foot and ankle. These may be taken with:

Your doctor may also inject a medicine in local structures. This can help your doctor confirm what structures are causing the problem.

Treatment

Talk with your doctor about the best plan for you. Treatment options include the following:

Immobilization

A cast, splint, or brace may be needed. They will help keep your foot and ankle from moving to let the tendon rest. You may also be asked to wear special shoes or inserts.

Medications

To help manage pain, your doctor may recommend:

  • Over-the-counter pain relievers, such as acetaminophen or non-steroidal anti-inflammatory medication (NSAIDs)
  • Prescription pain relievers
  • Corticosteroid injections
Physical Therapy

Physical therapy exercises will help to regain strength and range of motion within the foot and ankle. Other physical therapy methods include ice, heat, or ultrasound to reduce pain and swelling.

Surgery

Surgery may be needed in some cases. It can help to repair the tendon or adjust support structures of your foot.

Prevention

To help reduce your chance of getting peroneal tendinopathy, take the following steps:

  • Avoiding activities and sports that repeatedly stress the ankle.
  • Do not put yourself at risk for trauma to the ankle.
  • Build strong muscles to support your joints.
  • Gradually increasing the frequency and intensity of exercise.
  • Learn proper technique for sports and exercise.

RESOURCES:

American Orthopaedic Foot & Ankle Society
http://aofas.org

OrthoInfo.org—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://coa-aco.org

Canadian Orthopaedic Foundation
http://canorth.org

References:

ACR Appropriateness Criteria chronic ankle pain. AHRQ National Guideline Clearinghouse website. Available at: http://www.guideline.gov/content.aspx?id=15735. Accessed May 6, 2013.

Heckman D, Reddy M, Pedowitz D, et al. Operative treatment for peroneal tendon disorders. J Bone Joint Surg Am. 2008; 90:404-418.

Peroneal tendon injuries. American College of Food and Ankle Surgeons website. Available at: http://www.foothealthfacts.org/footankleinfo/peroneal-tendon.htm. Updated December 18, 2009. Accessed May 6, 2013.

Peroneal tendinopathy. EBSCO Dynamed website. Available at: http://www.ebscohost.com/dynamed. Accessed May 6, 2013.

4/24/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed April 24, 2014.



Last reviewed March 2014 by Teresa Briedwell, PT, DPT, OCS

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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